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e <br /> / Waste 11-0 No. 9190502 <br /> Syc .!4`i :M <br /> BROWNING-FERRIS INDUSTRIES NON-NALAkuJUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Jcrs _v ':;lana <br /> Santa Fe Railway :,ompnay Generating Location <br /> Generator Name g <br /> Address 740 East Carnegie Road Address Jersey Island, CA <br /> San Bernardino, CA 92408 <br /> Phone No. Phone No. <br /> BFI Waste Code M T Containers Type <br /> Description of Waste Quantity Units No. Type D-Drum <br /> 0 0 0 1 8 11!1 <br /> y ! T 0 C-Carton <br /> u B- Bag <br /> CONSTRUCTION DEMO LUMBER F-1m � T -Truck <br /> P -Pounds <br /> Y -Yards <br /> m El I <br /> O-Other <br /> hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, <br /> classified and packaged, and is in proper condition for transportation according to applicable regulations. <br /> Generator Authorized Agent Name Signature - Shipment Date <br /> TRANSPORTER <br /> 510-634-6850 <br /> Truck No. �� Phone No. / <br /> Transporter Name Dillard Trucking, Inc. 279/1 Driver Name (Print) —3.,h p "" <br /> Address P. 0. Box 218 Vehicle License No./State V"" Z <br /> Byron, California 94544 .3027<1 <br /> Vehicle Certification <br /> 1 hereby certifyth he above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the a or listed above. out inciden to thtination listed below. <br /> F97/ I S s <br /> D' r ignature Shipment Date Driv Signature Delivery Date <br /> DESTINATION <br /> I <br /> Site Name B.F.I. Vasco Road Landfill Phone No. <br /> 4001 North Vasco Rd. , Livermore, C. 94550 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> Name of Authorized Ag t Signature Receipt Date <br /> PASS CODE <br /> 10186 BF1260-72( <br /> jTRANSPORTER RETAIN <br />